Two cases of abnormalities of the left ventricular wall(left ventricular aneurysm or diverticulum) are presented. A saccular deformity of the left ventricle may be and aneurysm or a diverticulum. In one case, the defect seems to be subcalvular aneurysm(or fibrous diverticulum) or aneurysm of the membranous ventricular septum; this lesion seems to be a natural consequence of spontaneous closure of a defect of the membranous septum. The other case, it seems that the defect is ventricular aneurysm with syndrome of myocardial infarction and normal coronary arteries, or double or accessory chambered left ventricle. The thromboembolic phenomenon was noted on a left frontoparietal lobe of brain. Both cases have the diagnosis supported by cardiac catheterization and angiography. The clinical, angiographic and pathologic characteristic of diverticulum and aneurysm of the heart are reviewed, and an attempt is made to clarify the concept of aneurysm and diverticulum of the heart.
Aneurysm* ; Angiography ; Brain ; Cardiac Catheterization ; Cardiac Catheters ; Congenital Abnormalities ; Coronary Vessels ; Diagnosis ; Diverticulum* ; Heart ; Heart Ventricles* ; Myocardial Infarction ; Ventricular Septum

BACKGROUND: Melasma is an acquired, symmetrical hypermelanosis that occurs on sun-exposed areas of the skin. It has significant emotional and psychological effects on those affected with the condition. Melasma Quality of Life Scale (MELASQOL) is a specific questionnaire to identify the most impaired areas of melasma patient's life. OBJECTIVE: Our purpose of this study is to investigate the changing of MELASQOL after the treatment of melasma. METHODS: A total of 27 volunteers with melasma were enrolled in this 8-week treatment study. The patients were instructed to apply an arbutin-containing cream, once a day for 8 weeks. The assessment of outcomes included the colorimetric value (L*) and MELASQOL score. RESULTS: The arbutin-containing cream group increased more in the colorimetric values (L*) after the 8-week treatment (p<0.01). The MELASQOL score was decreased (p=0.02). No significant adverse reactions were observed. CONCLUSION: The treatment of melasma improves the QOL of melasma patients.
Humans ; Hyperpigmentation ; Melanosis ; Quality of Life ; Skin ; Surveys and Questionnaires

Hiatal hernias are usually classified into three distinct types: type I, sliding hernias; type II, paraesophageal hernias; and type III, a combination of types I and II. Paraesophageal herniation is an uncommon disorder accounting for approximately 5% of all hernias at the esophageal hiatus. Laparoscopic repair of paraesophageal hernias is rapidly replacing the traditional open approach. However, several series have shown high recurrence rates due to the difficulty in closing the hiatal gap. A 28-year-old male patient presented with no symptoms including reflux symptom, but a herniation of the transverse colon and omentum into the thorax to the right side of the esophageal hiatus of the diaphragm was found. The anatomy of the stomach and small bowel loops were unremarkable. After reduction of the colon and omentum, the defect was closed and reinforced using Prolene mesh via a laparoscopic procedure. The patient recovered early, with no complication, and has been recurrence free during the 8 months of followed up.
Adult ; Colon ; Colon, Transverse ; Diaphragm ; Hernia ; Hernia, Diaphragmatic* ; Hernia, Hiatal ; Humans ; Laparoscopy ; Male ; Omentum ; Polypropylenes ; Recurrence ; Stomach ; Thorax

PURPOSE: To evaluate near, intermediate, and distant vision, optical quality, and patient satisfaction with Acri.LISA aspheric diffractive multifocal IOL. METHODS: Forty eyes of 20 patients received phacoemulsification and implantation of Acri.LISA IOL. Visual acuity was measured postoperatively at 1 week, 1 month, and 6 months. Contrast sensitivity, wavefront aberration, and visual function via questionnaire were measured at postoperative 1 month. RESULTS: Uncorrected near, intermediate, and distanct visual acuity at 1 month were 0.09 +/- 0.14, 0.29 +/- 0.17 and 0.11 +/- 0.12, respectively. At 6 months, similar visual acuity results were measured. Total and higher-order wavefront aberration values were 0.66 +/- 0.29 and 0.24 +/- 0.08, respectively. Photopic contrast sensitivity at 1.5, 3, 6, 12, and 18 cycles/degree were 1.38 +/- 0.32, 1.73 +/- 0.24, 1.75 +/- 0.21, 1.33 +/- 0.18, and 0.77 +/- 23, respectively, and mesopic contrast sensitivity values were 1.37 +/- 0.27, 1.72 +/- 0.16, 1.63 +/- 0.14, 1.01 +/- 0.19, and 0.50 +/- 0.22. Total subjective visual function score was 3,127 +/- 354, near work was 244 +/- 36, distance work was 256 +/- 21, and night driving was 221 +/- 42. CONCLUSIONS: The Acri.LISA 366D multifocal IOL can be effective for improving patient satisfaction after cataract surgery as well as for presbyopia correction.
Cataract ; Contrast Sensitivity ; Eye ; Humans ; Lenses, Intraocular ; Patient Satisfaction ; Phacoemulsification ; Presbyopia ; Surveys and Questionnaires ; Vision, Ocular ; Visual Acuity

No abstract available.
Anti-Infective Agents* ; Compliance*

BACKGROUND: Many strategies have been developed to guide more appropriate and cost-effective antibiotic use in hospitals. This study was done to evaluate compliance and short-term impact of targeted antibiotic advisory consult implemented in our hospital since October 2002. Materials and METHODS: A total of 339 prescriptions in 187 patients were retrospectively reviewed and antimicrobial utilization density was compared quarterly from January 2002 through June 2003. RESULTS: Overall, 85.6% of prescriptions were inappropriate, with 73.7% being inappropriate for therapeutic regimens and 100% for prophylactic regimens. Overall compliance was 46.5%. The compliance was higher in the medical services than in the surgical services (64.2% vs. 43.1%, P=0.005) and for therapeutic use than for prophylactic use (54.7% vs. 36.5%, P=0.001). From 1Q 2002 to 2Q 2003, use of aminoglycosides was reduced from 269.1 AUD to 171.8 AUD, and that for antipseudomonal cephalosporins from 112.1 AUD to 64.5 AUD (both, P<0.01). Overall, inpatient use of parenteral antibiotics was decreased from 770.8 AUD to 626.8 AUD (P<0.01). CONCLUSION: Targeted antibiotic advisory consult resulted in substantial reduction in antibiotic use despite relatively poor compliance. This type of antibiotic control program can be an alternative for hospitals with limited human resources trying to implement an antibiotic policy.
Aminoglycosides ; Anti-Bacterial Agents ; Anti-Infective Agents* ; Cephalosporins ; Compliance* ; Humans ; Inpatients ; Prescriptions ; Retrospective Studies

No abstract available.
Anti-Infective Agents* ; Compliance*

BACKGROUND: Many strategies have been developed to guide more appropriate and cost-effective antibiotic use in hospitals. This study was done to evaluate compliance and short-term impact of targeted antibiotic advisory consult implemented in our hospital since October 2002. Materials and METHODS: A total of 339 prescriptions in 187 patients were retrospectively reviewed and antimicrobial utilization density was compared quarterly from January 2002 through June 2003. RESULTS: Overall, 85.6% of prescriptions were inappropriate, with 73.7% being inappropriate for therapeutic regimens and 100% for prophylactic regimens. Overall compliance was 46.5%. The compliance was higher in the medical services than in the surgical services (64.2% vs. 43.1%, P=0.005) and for therapeutic use than for prophylactic use (54.7% vs. 36.5%, P=0.001). From 1Q 2002 to 2Q 2003, use of aminoglycosides was reduced from 269.1 AUD to 171.8 AUD, and that for antipseudomonal cephalosporins from 112.1 AUD to 64.5 AUD (both, P<0.01). Overall, inpatient use of parenteral antibiotics was decreased from 770.8 AUD to 626.8 AUD (P<0.01). CONCLUSION: Targeted antibiotic advisory consult resulted in substantial reduction in antibiotic use despite relatively poor compliance. This type of antibiotic control program can be an alternative for hospitals with limited human resources trying to implement an antibiotic policy.
Aminoglycosides ; Anti-Bacterial Agents ; Anti-Infective Agents* ; Cephalosporins ; Compliance* ; Humans ; Inpatients ; Prescriptions ; Retrospective Studies

Over 26 kinds of tablets and capsules, such as Tetracycline, Quinidine and Potassium preparations were reported to cause esopbageal ulcerations, eharacterized in various size, shape and number, ind sually in mid-esophagus, Recently authors experienced 10 cases of drug-induced esophageal ulcerations due to antibiotics and antiinflammatory agents such as Tetracycline, Aspirin, etc. Four cases were men and six were women. Four cases were in third dades, three in fourth cleeades, two in fifth decades and one in sixth decades. Presenting symptoras were odynophagia(4/10), dysphagia(3/10), substernal pain(7/10) and epigastric pain(3/10). Endoscopic examination of the esophgus showed single or multiple, small and shallow ulcers on the mid-esophgeal mucosa at the level of 30cm from the ineisor in eight cases, one Iarge and deep ulcer at the level of 40cm from incisor in one patient and one amall, shallow and one large, deep ulcers at the same time. in one patient The shape of alcers were various from a round to a large horseshoe shaped one. The clinical course was mild without complications. It was suggested that drug-induced esophsgeal ulcers with antibiotics and antiinflammatory agents could be found frequently and they had benign and mild clinicalc ourse,
Anti-Bacterial Agents ; Anti-Inflammatory Agents ; Aspirin ; Capsules ; Female ; Humans ; Incisor ; Male ; Mucous Membrane ; Potassium ; Quinidine ; Tablets ; Tetracycline ; Ulcer*

We reviewed 49 cases of moderate or severe pericardial effusion on which we performed pericardiocentesis and percutaneous pericardial biopsy from Jan. 1987 to Sep. 1989. Of these, 11 cases were performed percutaneous pericardial biopsy in order to diagnose confirmative. We studied clinical manifestation including physical examination, ECG, and radiology, etiology and complication of pericardiocentesis and percutaneous pericardial biopsy. The results are as belows : 1) The physical examination of pericardial effusion were neck vein engorgement(73.5%), priction rub(25.5%), and pulsus paradoxus(4%). The ECG findings were low voltage(77.6%) and electrical alternans(16.5%), and most common x-ray finding was cardiomegaly (81.6%). 2) Underlying diseases were as follows : neoplastic disease(40.8%), tuberculosis(18.4%) systemic lupus erythematosus(10.2%), hemopericardium(8.2%), chronic renal failure(6.1%), congestive heart failure(4.1%), idiopathic pericarditis(4.1%), GVHD(2.0%), pyopericardium(2.0%), rheumatic carditis(2.0%), and postpericardiotomy syndrome(2.0%), in order. 3) Special etiologic diagnosis of neoplasm were lung cancer(50%), adenocarcinoma of unknown origin(20%), Malignant lymphoma(15%), stomach cancer(5%), hepatoma(5%), and malignant thymoma(5%), in order. From the percutaneous pericardial biopsy, the authors confirmed 36% by finding two cases of malignancy and two cases of tuberculosis. On the other hand, only one case was confirmed in cytology. These result in a rather low rate of diagnostic confirm. There were 8 cases of complication : hypotension(8.2%), premature ventricular contraction(6.1%) and ventricular tachycardia (2.0%) without death cases. In percutaneous pericardial biopsy, only two cases of hypotension were found with no death case. The result obtained from the above 11 cases of percutanous pericardial biopsy is not enough to make conclusive statement concerning rate of diagnostic confirmation and complication. We expect better results by examining more cases in the future.
Adenocarcinoma ; Biopsy* ; Cardiomegaly ; Diagnosis ; Electrocardiography ; Estrogens, Conjugated (USP) ; Hand ; Heart ; Humans ; Hypotension ; Lung ; Neck ; Pericardial Effusion ; Pericardiocentesis* ; Physical Examination ; Stomach ; Tachycardia, Ventricular ; Tuberculosis ; Veins